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Diseases » Incontinence » Causes
 

Causes of Incontinence

Contents
  1. Incontinence: Introduction
  2. Drugs/substances (18 causes)
  3. Drug interaction (202 causes)
  4. Excerpts from book chapters
  5. Complication causes
  6. Causes of symptoms
  7. News
  8. Related cause information

Causes of Incontinence (Diseases Database):

The follow list shows some of the possible medical causes of Incontinence that are listed by the Diseases Database:

Source: Diseases Database

Incontinence Causes: Book Excerpts

Incontinence as a complication of other conditions:

Other conditions that might have Incontinence as a complication may, potentially, be an underlying cause of Incontinence. Our database lists the following as having Incontinence as a complication of that condition:

Incontinence as a symptom:

Conditions listing Incontinence as a symptom may also be potential underlying causes of Incontinence. Our database lists the following as having Incontinence as a symptom of that condition:

Medications or substances causing Incontinence:

The following drugs, medications, substances or toxins are some of the possible causes of Incontinence as a symptom. This list is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

See full list of 18 medications causing Incontinence


Drug interactions causing Incontinence:

When combined, certain drugs, medications, substances or toxins may react causing Incontinence as a symptom.

The list below is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

  • Cibalith-S and Accupril (Quinapril) interaction
  • Cibalith-S and Altace (Ramipril) interaction
  • Cibalith-S and Capoten (Captopril) interaction
  • Cibalith-S and Lotensin (Benazepril) interaction
  • Cibalith-S and Monopril (Fosinopril) interaction
  • more interactions...»

See full list of 202 drug interactions causing Incontinence

Medical news summaries relating to Incontinence:

The following medical news items are relevant to causes of Incontinence:

Related information on causes of Incontinence:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Incontinence may be found in:

Causes of Incontinence: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Incontinence.

Incontinence: Differential Diagnosis
(In a Page: Signs and Symptoms)

Transient, acute incontinence (DIAPPERS)

  • Delirium
  • Infections of urinary tract
  • Atrophic urethritis or vaginitis
  • Pharmaceuticals [e.g., diuretics, sedatives, anxiolytics, alcohol, β-blockers (cause urethral relaxation), ACE inhibitors (chronic cough increases abdominal pressure), antidepressants, antipsychotics]
  • Psychiatric conditions (e.g., depression)
  • Endocrine disorders (e.g., hypercalcemia, hyperglycemia)
  • Restricted mobility or (urinary)
  • Retention
  • Stool (fecal impaction)
    Persistent, chronic incontinence
  • Stress incontinence
    –Loss of urine upon increases in intra-abdominal pressure (e.g., laughing, coughing, change in position, exercise)
    –Women <60 years after vaginal births
    –Urethral trauma (e.g., prostate surgery)
  • Urge incontinence (“overactive bladder”)
    –Strong urge to urinate before reaching the toilet; usually in people >60
    –Commonly associated with reversible causes, increased fluid intake, or poor bladder contractility
    –Idiopathic causes, neurologic causes, hyperreflexia, neuropathies, poor bladder contractility, increased sphincter relaxation, and reversible causes (e.g., UTI, increased fluid intake)
  • Overflow incontinence
    –Outlet obstruction: BPH, GU prolapse, tumors
    –Bladder contractility dysfunction: Neurologic disorder (e.g., diabetic or alcoholic neuropathy), sacral spinal cord lesions, anticholinergic medications
  • Functional incontinence
    –Normal urinary system affected by external factors (e.g., age, mental status decline, poor mobility)
  • Mixed incontinence
    –Combined elements of stress and urge incontinence is common in older females
    –Combined elements of overflow and urge incontinence are most common in men and frail nursing-home patients
>

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Enuresis: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

  • Urinary tract infection (UTI)
    –Most common cause of new onset, secondary enuresis
    –Common pathogens: E. coli (85%), Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, and other gram-negatives
    • Primary nocturnal enuresis
      –Normal in children up to 8 years
      –Often there is a strong family history
      –Affected family members may not achieve night-time continence until adolescence
    • Dysfunctional voiding
      –Unstable (uninhibited) bladder of childhood
      –Infrequent voiding
      –Neurogenic bladder
    • Psychosocial stress
    • Chronic constipation
      –Often associated with encopresis
    • Chronic kidney disease
    • Nephrogenic diabetes insipidus (DI)
    • Central DI
    • Diabetes mellitus (DM)
    • Ectopic ureter
    • Posterior urethral valves
    • Urethral stricture
    • Developmental delay
    • Neurologic disease
      –Tethered cord
      –Spina bifida
      –Spinal tumors
      –Spinal dysraphism
    • Sexual abuse
    • Prostatic tumor or abscess
    • Hydrocolpos or hematocolpos
    • Osteomyelitis of vertebral body with compression of the spinal cord
    • Spinal epidural abscess
    • Obstructive sleep apnea
    • Giggle micturition

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Enuresis: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Detrusor muscle hyperactivity

Involuntary detrusor muscle contractions may cause primary or secondary enuresis associated with urinary urgency, frequency, and incontinence. Signs and symptoms of a UTI are also common.

Unirary tract obstruction

Although daytime incontinence is more common, urinary tract obstruction may produce primary or secondary enuresis. It may also cause flank and lower back pain; upper abdominal distention; urinary frequency, urgency, hesitancy, and dribbling; dysuria; a diminished urine stream; hematuria; and variable urine output.

UTI

In children, most UTIs produce secondary enuresis. Associated features include urinary frequency and urgency, dysuria, straining to urinate, and hematuria. Lower back pain, fatigue, and suprapubic discomfort may also occur.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Urinary incontinence: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Benign prostatic hyperplasia (BPH)

Overflow incontinence is common with BPH as a result of urethral obstruction and urine retention. BPH begins with a group of signs and symptoms known as prostatism: reduced caliber and force of urine stream, urinary hesitancy, and a feeling of incomplete voiding. As obstruction increases, urination becomes more frequent, with nocturia and, possibly, hematuria. Examination reveals bladder distention and an enlarged prostate.

Bladder cancer

The patient commonly presents with urge incontinence and hematuria; obstruction by a tumor may produce overflow incontinence. The early stages can be asymptomatic. Other urinary signs and symptoms include frequency, dysuria, nocturia, dribbling, and suprapubic pain from bladder spasms after voiding. A mass may be palpable on bimanual examination.

Diabetic neuropathy

Autonomic neuropathy may cause painless bladder distention with overflow incontinence. Related findings include episodic constipation or diarrhea (which is commonly nocturnal), impotence and
retrograde ejaculation, orthostatic hypotension, syncope, and dysphagia.

Multiple sclerosis (MS)

Urinary incontinence, urgency, and frequency are common urologic findings in MS. In most patients, visual problems and sensory impairment occur early. Other findings include constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, ataxic gait, dysarthria, impotence, and emotional lability.

Prostate cancer

Urinary incontinence usually appears only in the advanced stages of this cancer. Urinary frequency and hesitancy, nocturia, dysuria, bladder distention, perineal pain, constipation, and a hard, irregularly shaped, nodular prostate are other common late findings.

Prostatitis (chronic)

Urinary incontinence may occur as a result of urethral obstruction from an enlarged prostate. Other findings include urinary frequency and urgency, dysuria, hematuria, bladder distention, persistent urethral discharge, dull perineal pain that may radiate, ejaculatory pain, and decreased libido.

Spinal cord injury

Complete cord transection above the sacral level causes flaccid paralysis of the bladder. Overflow incontinence follows rapid bladder distention. Other findings include paraplegia, sexual dysfunction, sensory loss, muscle atrophy, anhidrosis, and loss of reflexes distal to the injury.

Stroke

Urinary incontinence may be transient or permanent. Associated findings reflect the site and extent of the lesion and may include impaired mentation, emotional lability, behavioral changes, altered level of consciousness, and seizures. Headache, vomiting, visual deficits, and decreased visual acuity are possible. Sensorimotor effects include contralateral hemiplegia, dysarthria, dysphagia, ataxia, apraxia, agnosia, aphasia, and unilateral sensory loss.

Urethral stricture

Eventually, overflow incontinence may occur here. As obstruction increases, urine extravasation may lead to formation of urinomas and urosepsis.

Urinary tract infection (UTI)

Besides incontinence, UTI may produce urinary urgency, dysuria, hematuria, cloudy urine and, in males, urethral discharge. Bladder spasms or a feeling of warmth during urination may occur.

Other causes

Surgery

Urinary incontinence may occur after prostatectomy as a result of urethral sphincter damage.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Fecal incontinence: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Dementia

Any chronic degenerative brain disease can produce fecal as well as urinary incontinence. Associated signs and symptoms include impaired judgment and abstract thinking, amnesia, emotional lability, hyperactive deep tendon reflexes, aphasia or dysarthria and, possibly, diffuse choreoathetoid movements.

Head trauma

Disruption of the neurologic pathways that control defecation can cause fecal incontinence. Additional findings depend on the location and severity of the injury and may include a decreased level of consciousness, seizures, vomiting, and a wide range of motor and sensory impairments.

Inflammatory bowel disease

Nocturnal fecal incontinence occurs occasionally with diarrhea. Related findings include abdominal pain, anorexia, weight loss, blood in the stools, and hyperactive bowel sounds.

Rectovaginal fistula

Fecal incontinence occurs in tandem with uninhibited passage of flatus.

Spinal cord lesions

Any lesion that causes compression or transsection of sensorimotor spinal tracts can lead to fecal incontinence. Incontinence may be permanent, especially with severe lesions of the sacral segments. Other signs and symptoms reflect motor and sensory disturbances below the level of the lesion, such as urinary incontinence, weakness or paralysis, paresthesia, analgesia, and thermanesthesia.

Other causes

Drugs

Chronic laxative abuse may cause insensitivity to a fecal mass or loss of the colonic defecation reflex

Surgery

Pelvic, prostate, or rectal surgery occasionally produces temporary fecal incontinence. Colostomy or ileostomy causes permanent or temporary fecal incontinence

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Neurogenic bladder: Causes
(Professional Guide to Diseases (Eighth Edition))

At one time, neurogenic bladder was thought to result primarily from spinal cord injury; now, it appears to stem from a host of underlying conditions:

❑ cerebral disorders, such as stroke, brain tumor (meningioma and glioma), Parkinson’s disease, multiple sclerosis, dementia, and incontinence caused by aging

❑ spinal cord disease or trauma, such as herniated vertebral disks, spina bifida, myelomeningocele, spinal stenosis (causing cord compression) or arachnoiditis (causing adhesions between the membranes covering the cord), cervical spondylosis, myelopathies from hereditary or nutritional deficiencies and, rarely, tabes dorsalis

❑ disorders of peripheral innervation, including autonomic neuropathies resulting from endocrine disturbances such as diabetes mellitus (most common)

❑ metabolic disturbances, such as hypothyroidism, porphyria, or uremia (infrequent)

❑ acute infectious diseases such as transverse myelitis

❑ heavy metal toxicity

❑ chronic alcoholism

❑ collagen diseases such as systemic lupus erythematosus

❑ vascular diseases such as atherosclerosis

❑ distant effects of cancer such as primary oat cell carcinoma of the lung

❑ herpes zoster

❑ sacral agenesis.

An upper motor neuron lesion (above S2 to S4) causes spastic neurogenic bladder, with spontaneous contractions of detrusor muscles, elevated intravesical voiding pressure, bladder wall hypertrophy with trabeculation, and urinary sphincter spasms. A lower motor neuron lesion (below S2 to S4) causes flaccid neurogenic bladder, with decreased intravesical pressure, increased bladder capacity and large residual urine retention, and poor detrusor contraction.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Enuresis: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Detrusor muscle hyperactivity

Involuntary detrusor muscle contractions may cause primary or secondary enuresis associated with urinary urgency, frequency, and incontinence. Signs and symptoms of UTI are also common.

Urinary tract obstruction

Although it usually causes daytime incontinence, this disorder may also produce primary or secondary enuresis as well as flank and lower back pain; upper abdominal distention; urinary frequency, urgency, hesitancy, and dribbling; dysuria; diminished urine stream; hematuria; and variable urine output.

UTI

In children, most UTIs produce secondary enuresis. Associated features include urinary frequency and urgency, dysuria, straining to urinate, and hematuria. Low back pain, fatigue, and suprapubic discomfort may also occur.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Urinary incontinence: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Benign prostatic hyperplasia (BPH)

Overflow incontinence is common in this disorder as a result of urethral obstruction and urine retention. BPH begins with a group of signs and symptoms known as prostatism: reduced caliber and force of the urine stream, urinary hesitancy, and a feeling of incomplete voiding. As the obstruction increases, the patient may develop urinary frequency, nocturia and, possibly, hematuria. Examination reveals bladder distention and an enlarged prostate.

Bladder calculus

Overflow incontinence may occur if the calculus lodges in the bladder neck. Associated findings vary but may include those of an irritable bladder: urinary frequency and urgency, dysuria, hematuria, and suprapubic pain from bladder spasms. Pelvic pain may be referred to the tip of the penis, vulva, low back, or heel and may be exacerbated by movement.

Bladder cancer

Urge incontinence and hematuria are common findings in bladder cancer; obstruction by a tumor may produce overflow incontinence. The early stages can be asymptomatic. Other urinary signs and symptoms include frequency, dysuria, nocturia, dribbling, and suprapubic pain from bladder spasms after voiding. A mass may be palpable on bimanual examination.

Diabetic neuropathy

Autonomic neuropathy may cause painless bladder distention with overflow incontinence. Related findings include episodic constipation or diarrhea (which is commonly nocturnal), impotence and retrograde ejaculation, orthostatic hypotension, syncope, and dysphagia.

Guillain-Barré syndrome

Urinary incontinence may occur early in this disorder as a result of peripheral and autonomic nerve dysfunction. The cardinal sign is progressive, profound muscle weakness, which typically starts in the legs and extends to the arms and facial nerves within 24 to 72 hours. Associated findings include paresthesia, dysarthria, nasal speech, dysphagia, orthostatic hypotension, tachycardia, fecal incontinence, diaphoresis, drooling, and pain in the shoulders, thighs, or lumbar region.

Multiple sclerosis (MS)

Urinary incontinence, urgency, and frequency are common urologic findings in MS. Visual problems and sensory impairment are usually the first symptoms. Other findings include constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, ataxic gait, dysarthria, impotence, and emotional lability.

Prostate cancer

Urinary incontinence usually occurs only in the advanced stages of prostate cancer. Urinary frequency and hesitancy, nocturia, dysuria, bladder distention, perineal pain, constipation, and a hard, irregularly shaped, nodular prostate are other common late findings.

Prostatitis (chronic)

Urinary incontinence may occur as a result of urethral obstruction from an enlarged prostate. Other findings include urinary frequency and urgency, dysuria, hematuria, bladder distention, a persistent urethral discharge, dull perineal pain that may radiate to other areas, ejaculatory pain, and decreased libido.

Spinal cord injury

Complete cord transection above the sacral level causes flaccid paralysis of the bladder. Overflow incontinence follows rapid bladder distention. Other findings include paraplegia, sexual dysfunction, sensory loss, muscle atrophy, anhidrosis, and loss of reflexes distal to the injury.

Stroke

Urinary incontinence may be transient or permanent in a stroke patient. Associated findings reflect the site and extent of the lesion and may include impaired mentation, emotional lability, behavioral changes, altered level of consciousness, and seizures. Sensorimotor effects may include contralateral hemiplegia, dysarthria, dysphagia, ataxia, apraxia, agnosia, aphasia, and unilateral sensory loss. Headache, vomiting, visual deficits, and decreased visual acuity may also occur.

Urethral stricture

Partial obstruction of the lower urinary tract due to trauma or infection produces urinary hesitancy, tenesmus, and decreased force and caliber of the urine stream. Urinary frequency and urgency, nocturia, and eventually overflow incontinence may also occur. As the obstruction increases, urine extravasation may lead to formation of urinomas and urosepsis.

UTI

Besides incontinence, a UTI may produce urinary urgency, dysuria, hematuria, cloudy urine and, in males, a urethral discharge. Bladder spasms or a feeling of warmth during urination may occur.

Other causes

Surgery

Urinary incontinence may occur after prostatectomy as a result of urethral sphincter damage.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Fecal incontinence: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Dementia

Any chronic degenerative brain disease can produce fecal as well as urinary incontinence. Associated signs and symptoms include impaired judgment and abstract thinking, amnesia, emotional lability, hyperactive deep tendon reflexes (DTRs), aphasia or dysarthria and, possibly, diffuse choreoathetoid movements.

Gastroenteritis

Severe gastroenteritis may result in temporary fecal incontinence manifested by explosive diarrhea. Nausea, vomiting, and colicky, peristaltic abdominal pain are typical. Other findings include headache, myalgia, and hyperactive bowel sounds.

Head trauma

Disruption of the neurologic pathways that control defecation can cause fecal incontinence. Additional findings depend on the location and severity of the injury and may include decreased level of consciousness, seizures, vomiting, and a wide range of motor and sensory impairments.

Inflammatory bowel disease

Nocturnal fecal incontinence occurs occasionally with diarrhea. Related findings include abdominal pain, anorexia, weight loss, blood in the stool, and hyperactive bowel sounds.

Multiple sclerosis

Fecal incontinence occasionally appears as one of this disorder’s extremely variable signs. Other effects depend on the area of demyelination and may include muscle weakness, ataxia, and paralysis; gait disturbances; sensory impairment, such as paresthesia and genital anesthesia; visual blurring, diplopia, or nystagmus; urinary disturbances; and emotional lability.

Rectovaginal fistula

Fecal incontinence occurs in tandem with uninhibited passage of flatus.

Spinal cord lesion

Any lesion that causes compression or transsection of sensorimotor spinal tracts can lead to fecal incontinence. Incontinence may be permanent, especially with severe lesions of the sacral segments. Other signs and symptoms reflect motor and sensory disturbances below the level of the lesion, such as urinary incontinence, weakness or paralysis, paresthesia, analgesia, and thermanesthesia.

Stroke

Temporary fecal incontinence occasionally occurs in a stroke patient but usually disappears when muscle tone and DTRs are restored. Persistent fecal incontinence may reflect extensive neurologic damage. Other findings depend on the location and extent of damage and may include urinary incontinence, hemiplegia, dysarthria, aphasia, sensory losses, reflex changes, and visual field deficits. Typical generalized signs and symptoms include headache, vomiting, nuchal rigidity, fever, disorientation, mental impairment, seizures, and coma.

Tabes dorsalis

This late sign of syphilis occasionally results in fecal incontinence. It also produces urinary incontinence, ataxic gait, paresthesia, loss of DTRs and temperature sensation, severe flashing pain, Charcot’s joints, Argyll Robertson pupils, and possibly impotence.

Other causes

Drugs

Chronic laxative abuse may cause insensitivity to a fecal mass or loss of the colonic defecation reflex.

Surgery

Pelvic, prostate, or rectal surgery occasionally produces temporary fecal incontinence. A colostomy or an ileostomy causes permanent or temporary fecal incontinence.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Urinary Incontinence: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Cystitis

❑ Benign prostatic hypertrophy

❑ Pelvic floor relaxation

❑ Drugs

❑ Prostatitis

❑ Diabetes

❑ Cough

❑ Multiple sclerosis

❑ Spinal cord compression

❑ Decreased cortical inhibition

❑ Vesicovaginal fistula

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Neurogenic bladder: Causes
(Handbook of Diseases)

At one time, neurogenic bladder was thought to result primarily from spinal cord injury; now, it appears to stem from a host of underlying conditions:

❑ cerebral disorders, such as cerebrovascular accident, brain tumor (meningioma and glioma), Parkinson’s disease, multiple sclerosis, and dementia

❑ spinal cord disease or trauma, such as spinal stenosis (causing cord compression) or arachnoiditis (causing adhesions between the membranes covering the cord), cervical spondylosis, myelopathies from hereditary or nutritional deficiencies and, rarely, tabes dorsalis

❑ disorders of peripheral innervation, including autonomic neuropathies resulting from endocrine disturbances such as diabetes mellitus (most common)

❑ metabolic disturbances, such as hypothyroidism, porphyria, or uremia (infrequent)

❑ acute infectious diseases such as Guillain-Barré syndrome

❑ heavy metal toxicity

❑ chronic alcoholism

❑ collagen diseases such as systemic lupus erythematosus

❑ vascular diseases such as atherosclerosis

❑ distant effects of cancer such as primary oat cell carcinoma of the lung

❑ herpes zoster

❑ sacral agenesis.

An upper motor neuron lesion (above S2 to S4) causes spastic neurogenic bladder, with spontaneous contractions of the detrusor muscles, elevated intravesical voiding pressure, bladder wall hypertrophy with trabeculation, and urinary sphincter spasms.

A lower motor neuron lesion (below S2 to S4) causes flaccid neurogenic bladder, with decreased intravesical pressure, increased bladder capacity and large residual urine retention, and poor detrusor contraction.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Urinary incontinence: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Benign prostatic hyperplasia

Overflow incontinence is common with benign prostatic hyperplasia (BPH) as a result of urethral obstruction and urine retention. The disorder begins with a group of signs and symptoms known as prostatism: reduced caliber and force of urine stream, urinary hesitancy, and a feeling of incomplete voiding. As obstruction increases, urination becomes more frequent, with nocturia and, possibly, hematuria. Examination reveals bladder distention and an enlarged prostate.

Bladder calculus

Overflow incontinence may occur if the stone lodges in the bladder neck. Associated findings vary but may include those of an irritable bladder: urinary frequency and urgency, dysuria, hematuria, and suprapubic pain from bladder spasms. Pelvic pain and pain referred to the tip of the penis, vulva, low back, or heel may occur. Pain may be exacerbated by movement.

Bladder cancer

With bladder cancer, the patient commonly presents with urge incontinence and hematuria; obstruction by a tumor may produce overflow incontinence. Symptoms may be absent during the early stages. Other urinary signs and symptoms include frequency, dysuria, nocturia, dribbling, and suprapubic pain from bladder spasms after voiding. A mass may be palpable on bimanual examination.

Diabetic neuropathy

Diabetic neuropathy may cause painless bladder distention with overflow incontinence. Related findings include episodic constipation or diarrhea (which is commonly nocturnal), impotence and retrograde ejaculation, orthostatic hypotension, syncope, and dysphagia.

Guillain-Barré syndrome

Urinary incontinence may occur early in Guillain-Barré syndrome as a result of peripheral and autonomic nerve dysfunction. The most prominent sign is progressive, profound muscle weakness, which typically starts in the legs and extends to the arms and facial nerves within 24 to 72 hours. Associated findings include paresthesia; dysarthria; nasal speech; dysphagia; orthostatic hypotension; fecal incontinence; diaphoresis; drooling; pain in the shoulders, thighs, or lumbar region; and tachycardia.

Multiple sclerosis

Urinary incontinence, urgency, and frequency are common urologic findings in multiple sclerosis. In most patients, vision problems and sensory impairment occur early. Other findings include constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, ataxic gait, dysarthria, impotence, and emotional lability.

Prostate cancer

Urinary incontinence usually appears only in the advanced stages of prostate cancer. Urinary frequency and hesitancy, nocturia, dysuria, bladder distention, perineal pain, constipation, and a hard, irregularly shaped, nodular prostate are other common late findings.

Prostatitis (chronic)

Urinary incontinence may occur as a result of urethral obstruction from an enlarged prostate. Other findings include urinary frequency and urgency, dysuria, hematuria, bladder distention, persistent urethral discharge, dull perineal pain that may radiate, ejaculatory pain, and decreased libido.

Spinal cord injury

Complete spinal cord transection above the sacral level causes flaccid paralysis of the bladder. Overflow incontinence follows rapid bladder distention. Other findings include paraplegia, sexual dysfunction, sensory loss, muscle atrophy, anhidrosis, and loss of reflexes distal to the injury.

Stroke

Urinary incontinence may be transient or permanent in stroke patients. Associated findings reflect the site and extent of the lesion and may include impaired mentation, emotional lability, behavioral changes, altered level of consciousness, and seizures. Headache, vomiting, visual deficits, and decreased visual acuity are possible. Sensorimotor effects include contralateral hemiplegia, dysarthria, dysphagia, ataxia, apraxia, agnosia, aphasia, and unilateral sensory loss.

Urethral stricture

Eventually, overflow incontinence may occur with urethral stricture. As obstruction increases, urine extravasation may lead to formation of urinomas and urosepsis.

Urinary tract infection

Besides incontinence, a UTI may produce urinary urgency, dysuria, hematuria, cloudy urine and, in males, urethral discharge. Bladder spasms or a feeling of warmth during urination may occur.

Other causes

Surgery

Urinary incontinence may occur after prostatectomy as a result of urethral sphincter damage.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Urinary Incontinence: Principal Causes of Urinary Incontinence
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

  1. Maturationaldelay
  2. Stress-related causes
  3. Urinary tract disorders
    1. Urinarytract infection
    2. Dysfunctional voiding disorders
    3. Lower urinary tract obstruction
    4. Ectopic ureter in girls
  4. Neurologic disorders
    1. Mentalretardation
    2. Neurogenic bladder
  5. Abdominal or pelvic mass
  6. Polyuria
  7. Primary psychologic disturbance

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Fecal Incontinence: Principal Causes of Fecal Incontinence
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

  1. Maturationaldelay or developmental conflict
  2. Stress-related factors
  3. Constipation
  4. Neurologic disorders
    1. Mentalretardation
    2. Spinal dysraphism
    3. Spinal cord injury
    4. Spinal cord tumor
  5. Primary psychologic disturbance

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Enuresis: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Detrusor muscle hyperactivity.Involuntary detrusor muscle contractions may cause primary or secondary enuresis associated with urinary urgency, frequency, and incontinence. Signs and symptoms of a UTI are also common.

Urinary tract obstruction.Although daytime incontinence is more common, urinary tract obstruction may produce primary or secondary enuresis. It may also cause flank and lower back pain; upper abdominal distention; urinary frequency, urgency, hesitancy, and dribbling; dysuria; a diminished urine stream; hematuria; and variable urine output.

UTI.In children, most UTIs produce secondary enuresis. Associated features include urinary frequency and urgency, dysuria, straining to urinate, and hematuria. Lower back pain, fatigue, and suprapubic discomfort may also occur.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Urinary incontinence: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Benign prostatic hyperplasia (BPH).Overflow incontinence is common with BPH as a result of urethral obstruction and urine retention. BPH begins with a group of signs and symptoms known as prostatism: reduced caliber and force of urine stream, urinary hesitancy, and a feeling of incomplete voiding. As obstruction increases, urination becomes more frequent, with nocturia and, possibly, hematuria. Examination reveals bladder distention and an enlarged prostate.

Bladder cancer.With bladder cancer, the patient commonly presents with urge incontinence and hematuria; obstruction by a tumor may produce overflow incontinence. The early stages may not produce symptoms. Other urinary signs and symptoms include frequency, dysuria, nocturia, dribbling, and suprapubic pain from bladder spasms after voiding. A mass may be palpable on bimanual examination.

Diabetic neuropathy.Autonomic neuropathy may cause painless bladder distention with overflow incontinence. Related findings include episodic constipation or diarrhea (which is commonly nocturnal), impotence and retrograde ejaculation, orthostatic hypotension, syncope, and dysphagia.

Multiple sclerosis (MS).Urinary incontinence, urgency, and frequency are common urologic findings in MS. In most patients, vision problems and sensory impairment occur early. Other findings include constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, ataxic gait, dysarthria, impotence, and emotional lability.

Prostate cancer.Urinary incontinence usually appears only in the advanced stages of prostate cancer. Urinary frequency and hesitancy, nocturia, dysuria, bladder distention, perineal pain, constipation, and a hard, irregularly shaped, nodular prostate are other common late findings.

Prostatitis (chronic).Urinary incontinence may occur as a result of urethral obstruction from an enlarged prostate. Other findings include urinary frequency and urgency, dysuria, hematuria, bladder distention, persistent urethral discharge, dull perineal pain that may radiate, ejaculatory pain, and decreased libido.

Spinal cord injury.Complete cord transection above the sacral level causes flaccid paralysis of the bladder. Overflow incontinence follows rapid bladder distention. Other findings include paraplegia, sexual dysfunction, sensory loss, muscle atrophy, anhidrosis, and loss of reflexes distal to the injury.

Stroke.With a stroke, urinary incontinence may be transient or permanent. Associated findings reflect the site and extent of the lesion and may include impaired mentation, emotional lability, behavioral changes, altered level of consciousness, and seizures. Headache, vomiting, visual deficits, and decreased visual acuity are possible. Sensorimotor effects include contralateral hemiplegia, dysarthria, dysphagia, ataxia, apraxia, agnosia, aphasia, and unilateral sensory loss.

Urethral stricture.Eventually, overflow incontinence may occur with a urethral stricture. As obstruction increases, urine extravasation may lead to formation of urinomas and urosepsis.

UTI.Besides incontinence, a UTI may produce urinary urgency, dysuria, hematuria, cloudy urine and, in males, urethral discharge. Bladder spasms or a feeling of warmth during urination may occur.

Other causes

Surgery.Urinary incontinence may occur after prostatectomy as a result of urethral sphincter damage.

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Source: Nursing: Interpreting Signs and Symptoms, 2007

Fecal incontinence: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Dementia.Any chronic degenerative brain disease can produce fecal as well as urinary incontinence. Associated signs and symptoms include impaired judgment and abstract thinking, amnesia, emotional lability, hyperactive deep tendon reflexes, aphasia or dysarthria and, possibly, diffuse choreoathetoid movements.

Head trauma.Disruption of the neurologic pathways that control defecation can cause fecal incontinence. Additional findings depend on the location and severity of the injury and may include a decreased level of consciousness, seizures, vomiting, and a wide range of motor and sensory impairments.

Inflammatory bowel disease.Nocturnal fecal incontinence occurs occasionally with diarrhea in inflammatory bowel disease. Related findings include abdominal pain, anorexia, weight loss, blood in the stools, and hyperactive bowel sounds.

Rectovaginal fistula.With a rectovaginal fistula, fecal incontinence occurs in tandem with uninhibited passage of flatus.

Spinal cord lesions.Any lesion that causes compression or transsection of sensorimotor spinal tracts can lead to fecal incontinence. Incontinence may be permanent, especially with severe lesions of the sacral segments. Other signs and symptoms reflect motor and sensory disturbances below the level of the lesion, such as urinary incontinence, weakness or paralysis, paresthesia, analgesia, and thermanesthesia.

Other causes

Drugs.Chronic laxative abuse may cause insensitivity to a fecal mass or loss of the colonic defecation reflex.

Surgery.Pelvic, prostate, or rectal surgery occasionally produces temporary fecal incontinence. Colostomy or ileostomy causes permanent or temporary fecal incontinence.

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Source: Nursing: Interpreting Signs and Symptoms, 2007

Daytime Incontinence: Daytime Incontinence - risk factors
(The 5-Minute Pediatric Consult)

  • Constipation
  • Recurrent UTIs
  • Diabetes mellitus/diabetes insipidus
  • ADD/ADHD
  • Developmental delay

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Source: The 5-Minute Pediatric Consult, 2008


 » Next page: Risk Factors for Incontinence

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